Fukuhara Shunichi, Sakushima Ken, Nishimura Masaharu
Department of Healthcare Epidemiology, Kyoto University School of Medicine and Public Health, Japan.
Brain Nerve. 2012 Mar;64(3):225-8.
Clinical research in Japan is still lacking in quality and quantity, and that situation is worsening. One important cause of those problems is the dearth of clinician-investigators. A recent change in the system for post-graduate clinical training affected the career paths of medical residents and reduced the number of young doctors who enter graduate school. Even those who are interested in clinical research now have incentives to avoid graduate school. In Japan, 19th-century biological absolutism is still the dominant paradigm in the medical-research community. Science for public health in the 21st century will benefit from a probabilistic paradigm, which can help to restore an appropriate balance between basic sciences and clinical research. Research done by clinician-investigators should be based on clinical questions that arise in medical practice. That research includes investigation of disease and practice, exploration of associations between causes and outcomes, evaluation of diagnostic tests, and studies of the efficacy of treatments and prevention strategies. We emphasize the importance of nurturing clinician-investigators for the development of clinical research in Japan. This may not be the fastest way to promote innovative drug development from academia, but it is certainly the best.
日本的临床研究在质量和数量上仍然不足，且这种情况正在恶化。这些问题的一个重要原因是临床研究人员的匮乏。近期研究生临床培训体系的变化影响了住院医师的职业发展路径，减少了进入研究生院的年轻医生数量。即使是那些对临床研究感兴趣的人现在也有动机避开研究生院。在日本，19世纪的生物绝对主义在医学研究界仍然是主导范式。21世纪的公共卫生科学将受益于概率范式，这有助于在基础科学和临床研究之间恢复适当的平衡。临床研究人员进行的研究应基于医学实践中出现的临床问题。该研究包括疾病与实践调查、病因与结果关联探索、诊断测试评估以及治疗和预防策略疗效研究。我们强调培养临床研究人员对日本临床研究发展的重要性。这可能不是促进学术界创新药物研发的最快方式，但肯定是最好的方式。
